History
A chronology of Dr. Richard B. Guttler's clinical work, teaching, and the development of thyroid.com.
Fourteen milestones
A timeline of Dr. Guttler's clinical work, teaching, and the development of thyroid.com.
Dr. Guttler began his internship at the University of Southern California Medical Center in 1967 after graduating from the University of Illinois College of Medicine in Chicago. This was the start of his clinical training.
From 1969 to 1971, Dr. Guttler served as a Captain in the United States Army Medical Corps. His military service proved to be far more than a duty obligation, it became the unexpected launching point for his entire career in thyroid medicine.
During his Army service, Dr. Guttler investigated and wrote papers on a meningitis outbreak among soldiers under his care. His research and clinical work on that outbreak caught the attention of Army medical leadership, and as a direct result he was awarded GI Bill funding to pursue advanced specialty training upon completing his service.
That funding enabled him to begin his Thyroid Fellowship at USC / Los Angeles County Medical Center, the fellowship that would define the rest of his professional life. In this sense, the Army was not a detour from his thyroid career, it was the reason it began.
Just after completing his Army service, Dr. Guttler began cross-training in thyroid cytology, the microscopic interpretation of fine needle aspiration specimens from the thyroid gland. Determined to learn from the very best, he traveled to Sweden to train with two world-renowned experts who had essentially defined the field, Dr. Torsten Löwhagen and Dr. Sixten Franzén of the Karolinska Institute in Stockholm.
Franzén and Löwhagen were pioneers of fine needle aspiration cytology of the thyroid. Their work in the 1950s and 1960s established FNA as a safe, accurate, and practical diagnostic tool, transforming how thyroid nodules were evaluated worldwide and sparing countless patients from unnecessary surgery. Training with them in Sweden gave Dr. Guttler a foundation in cytopathology that few American endocrinologists of his era possessed.
This combination of world-class training in Sweden and sustained mentorship from Dr. Kini and Dr. Abele made Dr. Guttler one of the most cytologically sophisticated endocrinologists in the United States, a distinction that later allowed him to establish his own on-site thyroid cytopathology laboratory and teach FNA cytology to a generation of endocrinologists through the AACE.
In 1980, Dr. Guttler traveled to Papua New Guinea as a visiting professor, where he performed the first needle biopsy of a thyroid nodule in the country and established a thyroid cytology clinic in liaison with the Santa Monica Thyroid Diagnosis Center. The hospital schedule board, photographed during the visit, records his name alongside the designation “Visiting Professor, 29.2.80.”
This was part of a broader pattern of international contributions that defined Dr. Guttler’s career. He would go on to perform the first thyroid needle biopsy at Nairobi Hospital in 1987, bringing the same diagnostic techniques to underserved medical communities across two continents.
In 1991, the medical world took notice when both President George H.W. Bush and First Lady Barbara Bush were diagnosed with Graves’ disease within months of each other, an extraordinary coincidence that captured national attention. The simultaneous diagnosis of husband and wife with the same autoimmune thyroid condition was medically remarkable and statistically rare.
Dr. Guttler was invited to appear on the NBC Today Show to explain Graves’ disease to a national audience and discuss the unusual circumstance of a married couple developing the same condition at the same time. The NBC Learn archives preserve a clip from the segment, titled “Hyperactive Thyroid Gland,” showing Dr. Guttler at his lightbox reviewing thyroid scan images, the same diagnostic tools he used daily at the Santa Monica Thyroid Diagnostic Center.
The appearance brought national visibility to thyroid disease at a moment when public awareness was low, and it reinforced Dr. Guttler’s standing as a leading voice in thyroid medicine at a time when the condition was rarely discussed outside specialist circles.
In 1996, Dr. Richard B. Guttler, M.D., F.A.C.E. launched thyroid.com from the Santa Monica Thyroid Diagnostic Center, located at 1328 16th Street, Santa Monica, California 90404, in the Swezey Institute Building. At a time when most medical practices had no web presence, Dr. Guttler recognized the internet as a transformative tool for patient education and physician referral.
The original site described the center as a comprehensive, state-of-the-art center for the diagnosis and treatment of thyroid disease, specializing in the performance and interpretation of thyroid biopsy cytopathology. It was rated a 3-Star Site by Magellan, one of the leading web directories of the era.
The homepage navigation reflected the full scope of the center’s services: Patient Information, Physician Information, Nuclear Medicine, On-Site Thyroid Laboratory, Cytopathology, Ultrasound, Off-Site Support, and Thyroid Fun Stuff. The site was designed by RG Images and last updated 9/1/96. Copyright 1996.
Contact information listed on the original site included phone (310) 393-8860, fax (310) 395-8147, outside California (800) 408-4909, and E-Mail: Dr.Guttler@thyroid.com.
Alongside the on-site thyroid laboratory, Dr. Guttler introduced thyroid ultrasound as a core diagnostic tool at the Santa Monica Thyroid Diagnostic Center at a time when the medical establishment was deeply skeptical. Academic physicians widely dismissed ultrasound as worthless for thyroid diagnosis, viewing it as a money-making procedure with no real clinical value.
Dr. Guttler disagreed. He presented a Grand Rounds lecture at USC on the use of ultrasound in thyroid diagnosis, and it changed minds. Colleagues who had been dismissive began to recognize that ultrasound offered real-time visualization of thyroid nodules and surrounding structures that no other tool could match.
Today, thyroid ultrasound is considered essential in the diagnosis and treatment of thyroid nodules and cancer. The first ultrasound machine shown here is the equipment he used when almost no one else in the field believed it mattered.
In the late 1990s, Dr. Guttler traveled to Orlando, Florida, to train in ultrasound-guided ethanol ablation for thyroid cysts at the thyroid clinic of Dr. Jack Baskin, one of the leading experts in the United States on the use of ethanol to treat cystic thyroid nodules.
Dr. Baskin subsequently published the definitive reference work on the subject in 2000. His clinic in Orlando was one of the few places in the country where this technique was being taught and refined at that time.
Ethanol ablation works by injecting a small amount of ethanol directly into a cystic nodule under ultrasound guidance, causing the cyst wall to collapse and the fluid to be reabsorbed. For predominantly cystic thyroid nodules, it remains effective in well-selected cases, with no need for surgery or general anesthesia.
This early training shaped Dr. Guttler’s long-term approach to thyroid nodule ablation: use ethanol for predominantly cystic nodules, and reserve radiofrequency ablation for solid and mixed nodules.
For three consecutive years, Dr. Guttler taught a course on thyroid fine needle aspiration cytology for endocrinologists at the national thyroid cancer symposium of the American Association of Clinical Endocrinologists. The course, Thyroid FNA and Diagnostic Cytology for Endocrinologists, was sponsored by AACE and brought together practicing endocrinologists from across the country.
Teaching FNA cytology was a natural extension of Dr. Guttler’s clinical work at the Santa Monica Thyroid Diagnostic Center, where he had been performing and interpreting thyroid biopsies since the late 1970s. His ability to perform the biopsy, prepare slides, and interpret the cytopathology himself was unusual in the field and gave him a depth of hands-on expertise that translated directly into teaching.
The course reflected his standing as a national authority on thyroid cytopathology at a time when FNA biopsy was becoming the standard first-line diagnostic tool for thyroid nodules.
Records show thyroid.com expanding through the late 1990s, adding dedicated pages for each service and a full biography of Dr. Guttler.
The biography described Dr. Guttler as an internationally respected authority on thyroid disease with personal experience in needle biopsy cytopathology and interpretation. He graduated from the University of Illinois College of Medicine in Chicago, served his internship and residency at USC Medical Center, became a licensed physician in California in 1968, and was board certified in internal medicine in 1972 with further board certification in endocrinology in 1973.
Dr. Guttler trained in FNA and biopsy since 1977 with leaders in the field. Dr. Sudha Kini sponsored him for membership in A.S.C. He served a Special Research Fellowship at the National Institutes of Health, Division of Arthritis and Metabolic Diseases, at USC School of Medicine under Dr. John T. Nicoloff from 1972 to 1974. His clinical endocrinology fellowship came under Dr. Richard Horton, Chief of the Endocrine Division, USC LAC Medical Center.
He trained as a Royal Society of Medicine Travelling Fellow in London under Dr. Reginald Hall, received further training in thyroid nuclear medicine and radioisotopes from Dr. Jan K. Siemsen at USC Medical Center, and published and presented papers on cytopathology of the thyroid gland.
Among his notable international contributions, he performed the first needle biopsy of a thyroid nodule in Papua New Guinea in 1980, established a thyroid cytology clinic there, performed the first thyroid needle biopsy at Nairobi Hospital in 1987, and served as a volunteer doctor to patients of the Venice Family Clinic.
As the internet matured through the 2000s, thyroid.com evolved from a clinical practice website into a broader patient education resource. The focus shifted toward substantive, reliable thyroid health information for patients nationwide.
Dr. Guttler’s decades of clinical experience, seeing thousands of thyroid patients over a 50-year career, gave the site an authority and depth that distinguished it from the growing number of general health information sites. The site addressed questions patients actually asked about diagnosis, treatment options, the emotional burden of chronic thyroid disease, and how to navigate a medical system that often moved too quickly.
Content expanded to cover thyroid cancer in depth, including the psychological dimensions of a cancer diagnosis that most clinical resources ignored. Dr. Guttler’s direct, patient-centered voice became the defining characteristic of the site.
Through the 2010s, the site developed a distinctive body of work examining the emotional and psychological dimensions of thyroid disease. Dr. Guttler observed that the medical literature addressed the biochemistry of thyroid disorders in detail while largely ignoring what patients actually experienced, including fear, anxiety, and the grief of a chronic diagnosis.
The site addressed thanatophobia, or fear of death, in the context of thyroid cancer diagnosis, the concept of thyroid disease as a lifetime disorder requiring lifetime management, and the emotional devastation that could accompany a new diagnosis. The Questions Outline, a structured framework for the questions every thyroid patient should ask their physician, became one of the site’s most-used resources.
Dr. Guttler’s willingness to engage directly with the hardest questions patients faced set thyroid.com apart from institutional health information sites. These were not topics found in standard patient education materials.
Dr. Guttler’s pioneering work in thyroid radiofrequency ablation began in 2017, years before the procedure gained mainstream acceptance in the United States. His effort to bring this non-surgical alternative to American patients was a story of persistence, international collaboration, and a commitment to sparing patients from unnecessary thyroid surgery.
In 2017, Dr. Guttler traveled to Reggio Emilia, Italy, to train with Dr. Roberto Valcavi, a leading practitioner of radiofrequency ablation for thyroid nodules. Dr. Guttler spent a week with Dr. Valcavi learning hands-on how to become an RFA physician. Combined with earlier collaboration with Dr. Jung Hwan Baek in Korea and support from RFA companies working to bring the technology to the United States, that training gave him a foundation to return home and champion RFA for American patients.
Dr. Guttler’s decades-long effort to bring thyroid RFA to the United States established him as an early advocate of non-surgical thyroid treatment. Current treatment decisions remain individualized and require qualified clinical review.
In 2022, thyroid.com was rebuilt from the ground up, preserving the depth of content and patient-centered voice that had defined the site for more than 25 years while bringing its design and technology into the modern era.
The rebuilt site retained the core mission of providing thyroid patients with the information, context, and emotional support they need to navigate a lifetime of managing their condition. Six major topic areas, including thyroid cancer, Armour Thyroid, thyroid symptoms, thyroid problems, the ten symptoms of thyroid problems, and the thyroid journal, were developed into comprehensive resources.
The blog section continued Dr. Guttler’s tradition of direct, substantive patient communication by addressing questions that matter to people living with thyroid disease.
From a 3-Star Magellan site in 1996 to a modern health information resource in 2022, thyroid.com remained one of the longest-running thyroid health websites on the internet, reflecting Dr. Guttler’s lifelong commitment to his patients.
thyroid.com has been registered and operated continuously since 1996. Dr. Richard B. Guttler, M.D., F.A.C.E. practiced as a private thyroid medical specialist for 50 years.
The information on this site is for educational purposes and does not constitute medical advice.